Lab Investigation of White Cell Disorders Flashcards
how were WBC’s numbers measures in the past?
Haemocytometer
- Neubauer Chamber
- Way of counting manually
- Grid system, count cells within the grid and get an idea of the cell concentration and number of cells
still used for bone marrow aspirates
what is used now to measure WBC numbers?
Advia
-Machine gives you a print out
- Based on size and granularity and thus you can characterise most cells
- Plotting density/granularity vs size
with a Full Blood Count, what 3 things do we look at?
Haemoglobin (Hb) White Cell (Blood) Count (WBC) Platelet Count (Plt)
out of all the WBC types, which is most frequently found in the body?
neutrophils (and then LYMPHOCYTES)
what is a Romanowsky Stain
2 main components:
1) Azure B or Methylene Blue (Basic Dyes)
2) Eosin Y (Acidic Dye)
Buffer - pH 6.8
used to differentiate cells for microscopic examination in pathologic specimens, especially blood and bone marrow films
what stains purple?
All WBC’s have a nucleus that will stain purple – multi lobed nucleus
another word for neutrophil?
granulocyte, contains granzymes and perphorin
lymphocyte nucleus?
round, occupies majority of the cell
types of lymphocytes?
3
T and B cells
Natural Killer (NK) cells
major role of lymphocytes?
in Adaptive Immune Response
Differentiation between self and non-self
e.g. Viral attack
Lymphocytes produce antibodies to destroy that virus
Memory cells
lymphocytes vs granulocytes (in terms of their function)
Lymphocytes mainly involved in viruses whereas granulocytes (aka neutrophils) are more involved in bacteria
lymphocyte functions
T-cells are involved in Cell-Mediated Immunity - CD4+ T-Helper cells, CD8+ Cytotoxic T-cells
B-cells in Humoral Immunity i.e. Antibody Production
NK cells are part of the Innate Immune System attacking virally infected cells and tumour cells
how many lineages arise in the bone marrow?
2
Myeloid Progenitor Cell
Lymphoid Progenitor Cell
another name for WBC?
leucocyte
Leucocytosis vs Leucopenia
cytosis - Increase in white cells
penia - Decrease in white cells
Neutrophilia
Increase in neutrophils
Neutropenia
Decrease in neutrophils
steroids can cause what?
an increase in neutrophils
what is Toxic Granulation?
in response to infection the granules become more toxic and larger
-in terms of myeloid maturation, the pathway shifts to the left and you will see a lot more of the immature cells present in the blood (You should only see the mature neutrophils in the blood)
indication for myeloid leukemia?
Lots of myeloblasts present in a blood film
when might Neutrophilia occur?
as part of a normal physiological reaction (post-operative, pregnancy)
or because of inflammation or bacterial infection
or because of carcinoma, steroid treatment, myeloproliferative disorders, or treatment with myeloid growth factors
how is neutrophilia investigated?
FBC and differential white cell count
Blood film examination
Bone marrow examination + chromosome analysis for chronic myeloid leukaemia (Philadelphia
chromosome: translocation between ch 9 and 22)
Molecular analysis for BCR-ABL oncogene
when might Neutropenia occur?
Viral Infection
Drug Induced e.g. sulphonamides
Radiotherapy and chemotherapy
Part of a pancytopenia in bone marrow failure (aplastic anaemia) or infiltration e.g. leukaemia
causes of Eosinophilia?
Allergic diseases (asthma/hayfever) Parasitic infections Drug sensitivity Myeloproliferative diseases (chronic myeloid leukaemia) Hodgkin’s Lymphoma
Investigation of Eosinophilia?
FBC and differential white cell count
Blood film examination
Stool examination for ova and parasites
causes of Monocytosis
Tuberculosis (TB)
Acute and chronic monocytic and myelomonocytic leukaemia
Malaria
Investigation of Monocytosis
FBC and differential white cell count
Blood film examination:
- for abnormal white blood cells - for malarial parasites
Bone marrow examination - leukaemia
TB cultures
causes of Lymphocytosis
lymphocytosis of childhood, 1-6 years
Bacterial Infection
Viral Infections e.g. Hepatitis Mumps Rubella Pertussis Glandular Fever
Leukaemias and lymphomas
Investigation of Lymphocytosis?
FBC and differential white cell count
Blood film examination
Infectious Mononucleosis (Glandular Fever)
Heterophile antibodies are antibodies which react against an antigen which is completely unrelated to the antigen which originally stimulated them
e.g. Human antibodies reacting against sheep
or horse or bovine cells
Immunophenotyping use?
to determine if lymphocytes are:
B-cells: Demonstrate clonality by light chain restriction
or T-cells: Demonstrate clonality by T-cell Receptor Gene Rearrangement Studies
